Confessions of a displaced, pre-1968 Democrat.

09/02/2009

What Does The Public Option Mean?

The heated month of August, not just in terms of summer temperatures, but for the health care debate, is over. Congress will return to session having caught an earful from angry voters over health care reform. Obama is sliding in his approval ratings to a level at which his re-election can be cast in reasonable doubt. Republicans are resurgent, having found an issue around which they can unify their fractured coalition. And Democrats are divided, with liberals angry that the president backed off “the public option” and calling for all-out partisanship to get a bill passed, and moderates believing that such a retreat is necessary to secure a bipartisan program that will stand the test of time. Recently, comments from a prominent Democratic leader invited food for thought.

Senator Charles Schumer (D-NY) is a man of the Left in every way in terms of his own views. He’s a camera hound who makes Brett Favre look like a hermit by comparison. On the flip side, he’s used his position as head of the Democrats’ Senate Campaign Committee, an organization that distributes campaign money to Senate candidates, to invite pro-life and pro-gun Democrats into the party, even if he himself is at odds with them on these issues. In discussing health care, he believes Obama needs to launch a stronger argument for the public option, specifically drawing an analogy to the education system. The president, Schumer believes, should point out that in education we have both private and public schools. There is a choice. And that the public option in health care would amount to the same thing. It was a good analogy, and it unlocks both the positives and negatives of this proposal in one fell swoop.

Let’s start with the positives. The link to the education system debunks the key claim of the public option’s critics, which is that it will lead inexorably to socialized medicine, with its complete lack of real freedom. People still have freedom when it comes to choosing a school. We might add that most states have a public option when it comes to auto insurance, and has not led to a loss of free choice in this area. There is no reason a public option couldn’t function the same way.

But though I call that the “positives”, it’s really more neutral. It simply means that the idea might not be as world-ending as its leading conservative critics have charged. Whether it’s a positive or not depends on how it would be implemented, and its here that the analogy to the education system is not at all reassuring. In this space one week ago (two posts down), I laid out some thoughts on the schools. It is true that people have a choice in education. But how many can really afford it? The “public option” in education has spawned the growth of powerful special interests—the teachers’ union in this case—that has effectively hotwired the system so that only those who are well-off can go to private schools, while everyone else remains stuck on the public reservation. Tax dollars go almost exclusively to the public option, while private choices have to get money—through either donations or tuition—from people who can, in effect, afford to pay twice. Talk about a system geared to serve the rich.

What if health care goes down the same path? We’d have everyone in the health care system, and that would be all to the good. But will parents in the inner city be stuck with substandard care, while suburban families have access to the best? Will wealthy liberals opt out of the public option and pay for the best doctors, while denying efforts to give less-fortunate families the same choice? Will we end up with the equivalent of tax dollars going exclusively to the approved public choices, while private doctors have to send out fundraising letters? Will the public option spawn a huge special interest union dedicated to fighting for its own interests at the expense of all else? Let’s be frank—such is a very real possibility.

There is a possibility that real good could come from a public option. I have absolutely no use for the private insurance companies as they now exist. They have all but extorted money out of their customers as they continue to raise premiums and find reasons to deny or short claims. Their process is so cumbersome that one wonders what there is to fear from a government bureaucracy. In one of his finer moments in this debate, Barack pointed out that if the private insurers were doing as good a job as they claim to be, they would have nothing to fear from a public option—nobody would choose it.

If the marketplace were allowed to function normally, a public option can work. If it doesn’t, it will create a system that favors the rich. Senator Schumer’s analogy to the education system may provide persuasion that a public option doesn’t mean socialized medicine. But it doesn’t provide solace to those of us whose biggest fear is just how such an option would be implemented.

Everybody have a good holiday weekend! I’ve got a busy schedule lined up, with two baseball games, and some extra hours at work, so I’m not sure I’ll make my normal Saturday posting time. But I will be back either Sunday or Monday.

1 Comment

I am a 30 year old accounting student just trying to get informed on the subject. I'm definitely on the left, but the democrats don't make me comfortable. Just wanted to say that it's nice someone on the other side is making some concessions and creating possibilities. Your dialog is much more realistic than any of the rhetoric being thrown in our own Congress! The issues need to be talked about in a realistic manner. All I hear in the media and in the government are buzz words and scare tactics...from both sides. It's an awkward dance that distracts America from MAKING PROGRESS. We're never going to get anything done as long as our leaders are more interested in facebook and twitter wars.

I'm sick of it and I just wanted to say thanks for at least giving me an opposing view I can nod my head and say "I see your point." I wouldn't even say I'm very knowledgeable on the topic, but at least I'm trying to find facts, not yelling what some guy on tv is yelling just to be "patriotic."